We originally sent this letter on 4/02/03
to Arizona's Governor Janet Napolitano and the other Arizona officials
included in our cc. A similar letter has also been sent to officials in
other endemic states. The information in this letter reflects our
research at that time and thus does not include information we have
discovered since, like the more inclusive estimate of 10 million
infected Americans, the information about Nazis and
Valley Fever in World War II, and more. The letter still outlines the
need for strong regulation.

Dear Ms. Napolitano,

Coccidioides immitis is a fungus endemic to the
deserts of Arizona and is known to cause coccidioidomycosis, a disease better
known as cocci or Valley Fever.In
consideration of this disease’s threat to national security, C. immitis is
federally regulated as a select agent in the Antiterrorism and Effective Death
Penalty Act of 1996 and the Public Health Security and Bioterrorism
Preparedness and Response Act of 2002.Valley Fever is an incurable disease that can have debilitating
consequences, lay dormant and reactivate years later, and even cause
death.We know you are aware of the
consequences of this disease.Therefore, we have proposed some regulatory actions that are essential.

Federal regulations make it clear that any work expected to
involve C. immitis should be handled with Biosafety Level 3 regulations
(one step below agents like ebola).Construction workers, however, do not follow these regulations even when
working in the most endemic areas.By
disturbing the soil, they are spreading this fungal pathogen with no regard to
their own or public safety.This is
because most of them are unaware of the dangers of Valley Fever.In addition, selling land with C. immitis
in the soil is essentially a sale of this select agent, and buyers are usually
ignorant of the consequences of their purchase.

Even after searching through a great deal of travel
information and important facts to know about Arizona, I found no warning or
mention of this naturally occurring biohazard.The State of Arizona knew about cocci but chose not to inform visitors
about the dangers of this disease, thereby gambling with their health.I and countless others lost that
gamble.Many victims of Valley Fever
have died or been debilitated.

Increased construction in Arizona stirs up the ground to
make cocci spores airborne.Massive
migration has brought people into the areas where this fungus can be
inhaled.U.C. Davis estimates that 4.5
million people may already be infected with Valley Fever, and there is
presently a 3% annual infection rate in endemic areas.In Arizona alone, over 160,000 new
infections will occur in 2003.

Tragically, Valley Fever’s existence has been known for nearly
a century but the disease is virtually unknown to the public at large and even
to many doctors.How many more people
and animals have to be debilitated or die from this disease before Arizona
stands up and takes responsibility?Arizona not only allows but encourages people to come to and live in the
state without educating the public of the possible risks of this naturally
occurring biohazard.There are railroad
crossing signs, stop signs at intersections, warning labels on cigarettes, but
so far the state has not warned visitors or potential incoming students, new
employees, retirees, etc. about this dangerous incurable disease.Whether these people remain healthy depends
on the state’s veracity and concern.This means that the State of Arizona has a moral obligation to warn all
residents, visitors, tourists, etc. about the potentially debilitating
consequences they face as a result of contracting Valley Fever.

There are no signs to say, “beware of C. immitis
growing in your backyard, the desert or just free floating in the wind.”We at valleyfeversurvivor.com hope
Arizona will take our requests seriously.By failing to give its citizens and visitors the option for informed
consent about the dangers they face by breathing the biohazard in Arizona’s
air, we believe the state has displayed reckless disregard and endangerment for
the health of relocating families and pets, students, athletes, visitors like
myself, prospective retirees and Arizona’s own citizens.

We have attached a list of facts about this disease as well
as a list of regulatory proposals that will address the problem.We hope you will take this letter and our
request for immediate regulatory action to heart.President Bush has recently proposed Project Bioshield to help
companies work on vaccines to combat weapons of bioterrorism.Perhaps this will help as C. immitis
certainly falls under that heading.We
would like to see state and federal funding go to the vaccine project and to
further research for safer and better medicines.Hopefully this will lead to a cure someday as well.

Your response and the actions you take will be included in
our upcoming book on Valley Fever.We
look forward to your response.

Below is a short list of important facts about Valley
Fever.Although this is not
all-inclusive, we hope it will outline the need for immediate regulatory
actions in Arizona.

1) Coccidioides immitis is a fungus that can be used
as an agent of bioterrorism.

2) Once a person contracts coccidioidomycosis (cocci for
short and commonly known as Valley Fever) he or she is infected for life.

3) Presently there is no cure for Valley Fever.

4) Victims usually contract cocci simply by breathing and
cannot see the anthrax-sized fungal spores in the air.C. immitis spores are approximately
the same size as anthrax spores and can be inhaled at home through the ventilation
system, an open window, etc.

5) It is speculated that 60% of coccidioidal infections are
asymptomatic, but the disease can activate later to destroy the health of its
victims, debilitate, and kill them.

6) From our extensive research, no long-term research
studies to keep track of asymptomatic cocci infections that become symptomatic
could be found.

7) It appears to be a fallacy that most people who suffer
severe Valley Fever infections were already immune compromised.None of our questionnaire respondents had an
immune deficiency before suffering their Valley Fever infections.Only one questionnaire was submitted on
behalf of a deceased HIV-positive patient who died of Valley Fever.

8) Anyone at any age that is perfectly healthy can contract
Valley Fever and have a serious disseminated case or even die from the disease.

9) Since C. immitis tends to cause dramatically more
problems in African-Americans and Filipinos than in Caucasians, it has been
considered by the military for use as a race-specific pathogen for biological
warfare.

10) Senior citizens (60 years and older) are twice as likely
to report a Valley Fever infection than those 30-39 years of age.The CDC also indicates that Valley Fever
fatalities are more likely to occur among seniors.

11) We have received hundreds of surveys at
www.valleyfeversurvivor.com.Scarcely
any of them had significant health problems prior to contracting Valley
Fever.None appeared to be aware of the
lethal or debilitating consequences prior to their infection.

12) As a result of their Valley Fever infections, some
people have lost their jobs, health insurance, property, and homes.Some were rendered destitute and unable to
pay for dental procedures, car insurance, electricity, phone charges or even
their medication.

13) Despite the outstanding job and efforts of the Valley
Fever Center for Excellence (VFCE), our surveys to date indicate only a
miniscule six percent of respondents who have lived in endemic areas for seven
years or longer have a proper knowledge of Valley Fever.

14) Dr. Stuart Cohen at UC Davis estimates that 4,500,000
people in America are presently infected with Valley Fever.

15) This epidemic number above could be low, as Medical
Mycology states, “Between 1930 and 1960...it was established that
histoplasmosis and coccidioidomycosis infected over 100 million people in the
United States alone.”

16) Sixty-five percent of all Valley Fever cases occur in
Arizona.

17) Arizona does not require veterinarians to educate their
clients about the threat Valley Fever poses to them and their pets.Arizona also allows animals from non-endemic
areas to suffer needlessly by bringing them into local zoos where they can
inhale cocci spores easily.

18) Employees relocated into the state are routinely unaware
of Valley Fever, what it can do to them, their children, their pets, or what
they can do to mitigate the risk of infection.

19) Arizona real estate companies and their agents are not
required to tell any prospective customers about the existence of C. immitis
or the dangers of Valley Fever.

20) People are often uninformed about the dangers of
gardening in their yards, hiking, bike riding or camping in the desert.These activities can cause C. immitis
spores to become airborne.

21) The Chambers of Commerce and Tourist Bureaus do not send
information about the state’s naturally occurring biohazard in tourism
literature.Rather they entice people
to come, go camping in the desert, retire there, etc. without informing them of
the dangers.

22) The VFCE estimates that there are 100,000 new Valley
Fever infections annually.This is
based on population data from 1996 and the 3% annual likelihood of infection in
endemic areas.

23) When interpolating the 3% annual rate for the 2000
population census, the problem doubles to nearly 200,000 annual Valley Fever
infections.Even the 200,000 estimate
may be conservative, as the Southwest’s population continues to increase
rapidly in endemic areas.

24) There has been a 31% increase in the number of cocci
cases reported to the Valley Fever Center for Excellence from 2001-2002.

25) A NIOSH-approved N95 respirator is recommended for use
in areas where cocci is expected, but an N100 respirator may provide more
complete protection.These may mitigate
the chance of cocci infections during dust storms, digging, and construction.

26) C. immitis has been found in cotton exported from
endemic areas.Nationally and
internationally, workers coming into contact with it have been infected and at
least one has died.

27) Products purchased from roadside stands and brought out
of the state have contained C. immitis spores.Tourists need to be made aware of this danger.

28) Like the West Nile Virus, Valley Fever has been
transferred from organ donors to recipients.Increased testing is essential.

29) Despite the fact that disseminated coccidioidal
infections spread through the bloodstream, the American Association of Blood
Banks does not check the blood supply for cocci.

30) Cocci has hampered our military for decades, with the
first extensive studies tracking thousands of cases during World War II.

31) Cocci continues to adversely affect our homeland
security even in the present, as evidenced by a recent Navy SEAL training
exercise that had 45% of its team fall ill.

32) C. immitis spores have been known to travel
through the air as far as 500 miles outside their original endemic areas.

33) More often than not, Valley Fever cases are initially
misdiagnosed, leading to severe complications.

34) One of four college students with Valley Fever in
Arizona are sick for over four months.There were 36,847 students
in the University of Arizona in 2002.

35) “...too often Valley Fever is still perceived as simply
an annoyance by the general public, health care professionals and local
government officials.Even the majority
of local residents in the endemic area perceive Valley Fever as a relatively
benign disease.Combining this
misperception with a lack of knowledge about the disease among new residents,
tourists, new businesses, athletes and students moving into the endemic area,
creates a vast population base which must endure Valley Fever illnesses (often
without an accurate diagnosis) while being unprepared to deal with any possible
complications arising from a Coccidioides sp. infection.”
-- Robert J. Brauer, Jr., Executive Director VFCE, Valley Fever Center for Excellence Annual Report
2001-2002

REGULATORY ACTIONS
REQUIRED

In light of the information on our Facts Page and the fact
that I and countless others were not given any warning or knowledge of this
disease before visiting the state, valleyfeversurvivor.com
proposes the following for immediate implementation through legislative or
executive actions:

1) Fund research for a vaccine and a cure for Valley
Fever.

2) Provide the Valley Fever Center for Excellence (VFCE)
with the necessary funding to hire more personnel and to accomplish their goals
for education and research.

6) Require that coccidioidomycosis be noted as a patient’s
cause of death if a coccidioidal illness was at fault and not simply “fungal
pneumonia,” “organ failure,” “meningitis,” etc.

7) Prepare a document of up-to-date information about Valley
Fever (including items such as 1-5, 8-10, 14-16 and 23-35 listed in our Facts
Pages) as a state-approved uniform written material to provide information about
cocci’s dangers.All species of Coccidiodes
including C. immitis must be regulated and included in warnings of
Valley Fever.For the rest of this
document, this comprehensive written information about Valley Fever will be
referred to as VF Information.

8) Require all tourist bureaus and chambers of commerce
within the state to send the VF Information to anyone seeking information about
the state as well as providing the same VF Information on the web sites of all
state and government agencies.This must
be available to view at the front desks and given upon check-in at all tourism
and travel related businesses.

9) Require that the VF Information be sent to the
prospective visitors when travel and lodging reservations are made, with
confirmation notices, and with any other literature requests.

10) Require a mass mailing of the VF Information to the
households of all Arizona’s citizens.

11) Require all health care services to inform patients who
are Filipino, African-American, senior citizens, pregnant women, diabetics,
cancer patients, and any sick patient (immune compromised or not) about the
increased dangers they face if they contract Valley Fever or if the infection
reactivates.

12) Require all businesses and organizations that put on
conventions, sporting events, attractions, etc. in the state to mail the VF
Information to its participants, vendors, and attendees.

13) Require building contractors to supply the VF
Information to their employees and all prospective clients.

14) Require real estate agents and their companies to give
the VF Information to all prospective clients.

15) Require all owners of land privately selling their
property or home to provide all prospective purchasers with the VF Information.

16) Require all educational establishments in the state of
Arizona to provide all their prospective and current students with the VF
Information.

17) Require all businesses within the State of Arizona to
give the VF Information to all out-of-state prospective employees before they
enter the state.

18) Require all providers of vehicle and property rentals to
give the VF Information to their customers.

19) Require veterinarians to give the VF Information to all
their clients, whether their animals are presently infected or not.

20) Require that all vehicles transporting soil from this
state or any other endemic region must cover their load so any Coccidiodes
sp. spores that may be present can not be released during transport.

21) Require that all land where construction is planned be
assayed for Coccidiodes sp. to the depth the ground will be excavated
for construction.If Coccidiodes sp.
is found, the community surrounding that land must have the right to decide
whether to allow construction on that land to continue.

22) Require that any land development in Arizona adhere to
Biosafety Level 3 regulations whether or not Coccidiodes sp. is found,
as the fungus is frequently difficult to locate and the public health risk is
tremendous.Use of the appropriate
safety equipment (respirators, dust control measures, etc) must be enforced.